AI Article Synopsis
- Advanced lung disease patients with HLA antibodies face transplant challenges, but the impact of these antibodies on outcomes can vary.
- A study compared post-transplant survival and rejection rates between sensitized recipients with autoimmune interstitial lung disease (ILD) and those with nonautoimmune ILD.
- The results suggest that HLA antibodies from autoimmune ILD do not significantly affect bronchiolitis obliterans stage 1-free survival or antibody-mediated rejection, indicating similar treatment considerations for these patients as for other sensitized individuals.
Article Abstract
Introduction: Patients with advanced lung disease who have HLA antibodies against potential donors have reduced opportunities for transplant. Not all HLA antibodies, however, have the same impact on post-transplant outcomes. It is unknown whether HLA antibodies arising in the context of autoimmune lung disease are associated with increased antibody mediated rejection (AMR) or bronchiolitis obliterans stage 1 (BOS1)-free survival.
Methods: This study used retrospective data from SRTR to examine BOS1-free survival and AMR among sensitized recipients with autoimmune ILD compared to sensitization recipients with nonautoimmune ILD, accounting for other sources of sensitization such as pregnancy and blood transfusions. This study did not use organs from prisoners and participants were neither coerced nor paid.
Results: Sensitized recipients with autoimmune ILD did not have differences in BOS1-free survival when adjusting for sensitizing exposures (HR = 0.90, 95% CI: 0.70-1.16) or clinical covariates (HR = 0.96, 95% CI: 0.83-1.12). There was also no difference in AMR (OR = 1.92, 95% CI: 1.04-3.52).
Conclusions: HLA antibodies arising in the context of autoimmune ILD do not appear to have a differential impact on BOS1-free survival or AMR. This provides further evidence that patients sensitized via autoimmune lung diseases do not require separate decision-making regarding HLA antibody status compared to the overall sensitized population.
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| http://dx.doi.org/10.1016/j.transproceed.2024.06.006 | DOI Listing |
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